Table 1 Demographic characteristics and cardiovascular risk factors according to sex

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All (n=456) men (n=265) women (n=191) P value

Age (years) 61±13 61±13 62±12 0.23

Body mass index (kg/m²) 24±4 24±4 23±3 0.19

Current smoking, n (%) 125 (27) 112 (42) 13 (7) <0.01 Hypertension, n (%) 263 (58) 158 (60) 105 (55) 0.32 Dyslipidemia, n (%) 216 (84) 117 (44) 99 (52) 0.11 Diabetes mellitus, n (%) 178 (39) 110 (42) 68 (36) 0.2 Systolic blood pressure (mmHg) 129±19 129±18 129±20 0.32 Diastolic blood pressure (mmHg) 75±10 76±10 74±11 0.22 Total cholesterol (mg/dl) 192±37 185±35 201±38 <0.01 Triglycerides (mg/dl) 107 [70] 110 [82] 102 [60] 0.28 HDL cholesterol (mg/dl) 58±17 54±16 62±18 <0.01 LDL cholesterol (mg/dl) 115±30 111±30 120±30 <0.01

HemoglobinA1c (%) 6.6±1.7 6.6±1.6 6.5±1.8 0.67

Creatinine (mg/dl) 0.73±0.13 0.80±0.10 0.62±0.10 <0.01

eGFR (mL/min/1.73m²) 78±13 78±14 77±12 0.14

Cystatin C (mg/l) 0.91 [0.22] 0.96 [0.23] 0.88 [0.18] <0.01 Agatston score 8 [146] 24 [219] 0 [53] <0.01 Medications

ACEIs or ARBs, n (%) 148 (32) 89 (34) 59 (31) 0.57 β-blocker, n (%) 83 (18) 52 (20) 31 (16) 0.37 Calcium channel blockers, n (%) 120 (26) 72 (27) 48 (25) 0.65

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Statins, n (%) 122 (27) 61 (12) 61 (32) 0.03 Hypoglycemic agents, n (%) 130 (29) 82 (31) 48 (25) 0.18

Values are mean ± SD, n (%), or median [interquartile range].

eGFR, estimated glomerular filtration rate; ACEI, angiotensin-converting enzyme inhibitor, ARB;

angiotensin II receptor blocker. p value, men versus women.

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Table 2 Demographic characteristics according to the Agatston score

All

Mild CAC 0-9

Moderate CAC 10-399

Severe CAC

>400 (n=456) (n=235) (n=157) (n=64)

Age (years) 61±13 56±14 65±10 * 71±7 *,†

Men, n (%) 265 (58) 117 (50) 98 (62) * 50 (78) *,†

Body mass index (kg/m²) 24±4 23±4 24±4 23±3

Smoking, n (%) 125 (27) 69 (29) 38 (27) 18 (28) Hypertension, n (%) 263 (58) 119 (51) 106 (68) * 38 (59) Dyslipidemia, n (%) 216 (84) 99 (42) 87 (55) * 30 (47) Diabetes mellitus, n (%) 178 (39) 72 (31) 70 (45) * 36 (56) * Total cholesterol (mg/dl) 192±37 193±35 192±40 186±37 Systolic blood pressure (mmHg) 129±19 129±18 128±20 130±19 Diastolic blood pressure (mmHg) 75±10 76±10 74±11 75±10 Triglycerides (mg/dl) 107 [70] 105 [68] 107 [74] 108 [73]

HDL cholesterol (mg/dl) 58±17 59±17 55±17 60±18 LDL cholesterol (mg/dl) 115±30 116±29 116±31 107±31 Hemoglobin A1c (%) 6.6±1.7 6.5±1.9 6.7±1.7 6.6±1.0 Creatinine (mg/dl) 0.73±0.13 0.72±0.14 0.73±0.14 0.75±0.11

eGFR (mL/min/1.73m²) 78±13 78±14 77±12 75±12

Cystatin C (mg/l) 0.91 [0.22] 0.89 [0.22] 0.94 [0.21] 0.97 [0.16] * Medications

ACEI or ARB, n (%) 148 (32) 61 (26) 62 (39) * 25 (39) *

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β-blockers, n (%) 83 (18) 48 (20) 30 (19) 5 (8) *,†

Calcium channel blocker, n (%) 120 (26) 44 (19) 51 (32) * 25 (39) * Statin, n (%) 122 (27) 51 (22) 53 (34) * 18 (28) Hypoglycemic agents, n (%) 130 (29) 57 (24) 47 (30) 26 (41) *

Values are mean ± SD, n (%), or median [interquartile range].

eGFR, estimated glomerular filtration rate; ACEI, angiotensin-converting enzyme inhibitor, ARB;

angiotensin II receptor blocker.

*p<0.05 versus CAC of 0–9, †p<0.05 versus CAC of 10–399.

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Table 3 Multivariate predictors of severe CAC >400 in men and women with preserved renal function

All (n=456) Men (n=265) Women (n=191)

Univariate Multivariate Univariate Multivariate Univariate Multivariate

OR(95%CI) P value

OR (95%CI) P value

OR(95%CI) P value

Cystatin C (>

cutoff value)

2.49 (1.33-

4.65) <0.01

1.29 (0.63-

2.60) 0.49

4.04 (0.94-

17.49) 0.06

2.96 (0.62-

14.15) 0.2

6.95 (1.51-

31.976) 0.01

7.80 (1.76-

34.6) <0.01

Sex (men=1)

2.94 (1.57- 5.50)

<0.01

3.10 (1.46- 6.56)

<0.01

Hypertension

1.09 (0.63-

1.86) 0.77

0.73(0.38-

1.40) 0.34

0.83 (0.44-

1.55) 0.56

0.50(0.24-

1.0) 0.1

2.16 (0.65-

7.14) 0.21

1.74(0.28-

10.73) 0.6

Dyslipidemia

0.98 (0.58- 1.66)

0.93

1.25(0.58- 2.69)

0.56

0.73 (0.39- 1.38)

0.73

0.67(0.26- 17.67)

0.4

3.71 (1.00- 13.75)

0.05

9.45 (0.97- 91.99)

0.1

Diabetes Mellitus

2.26 (1.33- 3.88)

<0.01 2.36(1.27- 4.39)

<0.01 2.29 (1.22- 4.27)

0.01 2.90(1.39- 6.02)

<0.01 1.90 (0.64- 5.67)

0.25 1.35 (0.33- 5.51)

0.7

Smoking

1.12 (0.61-

2.04) 0.71

0.77(0.39-

1.53) 0.77

0.78 (0.41-

1.49) 0.45

0.80(0.39-

1.64) 0.5 N/A N/A N/A N/A

Age (>65) 4.97 (2.66- 9.28)

<0.01 4.67(2.33- 9.38)

<0.01 5.34 (2.64- 10.82)

<0.01 4.96 (2.24- 10.84)

<0.01 6.64 (1.45- 30.54)

0.01 2.60 (0.44- 15.23)

0.3

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Statin use 1.09 (0.60-

1.98) 0.78

0.82 (0.35-

1.93) 0.66

0.96 (0.46-

2.02) 0.91

1.22 (0.40-

3.69) 0.7

2.11 (0.71-

6.32) 0.18

0.80 (0.18-

3.60) 0.8

Cutoff values in all patients, men, and women were 0.88, 0.78, and 0.97 mg/dl, respectively.

N/A, not available